Here & Now

Bill Hanna on Impacts of Cutting Federal Social Safety Nets

Frederica Freyberg:
As we discussed earlier, cuts and changes to social safety net programs figure prominently in political discourse right now. In Wisconsin, by the numbers, nearly 1.3 million children and adults are enrolled in Medicaid, and 700,000 receive food share. For a closer look at how congressional changes to these programs could look in Wisconsin, we turn to Bill Hanna, Medicaid director at the Wisconsin Department of Health Services. And thanks for being here.

Bill Hanna:
Thank you. Happy to be here.

Frederica Freyberg:
We know what the House did on Medicaid and nutritional assistance. Cuts could go deeper under the Senate provisions. As it stands before Senate action, some analyses show nearly 230,000 people in Wisconsin could lose Affordable Care Act and Medicaid coverage. Is that what your analysis is showing?

Bill Hanna:
We focused our analysis on Medicaid. That’s where we have the specific data. Wisconsin’s part of the National ACA plan and really, we rely on national experts on the ACA data. But for Medicaid specifically, we estimate that 63,000 adults without children under the age of 18 would be at risk of losing their Medicaid coverage. I think it’s important to note that the coverage won’t just impact those individuals. It really impacts all of us because those individuals will still need to see their doctors or go to the hospital. They’ll just be uninsured. And those additional costs get passed on to all healthcare consumers.

Frederica Freyberg:
What is it in the bill that prompts people to lose that coverage?

Bill Hanna:
Yeah, the House bill creates a lot of additional red tape for this population to maintain their eligibility. First, it requires them to complete their Medicaid application or renewals every six months instead of once a year, as it is today. And it requires them to submit documentation to prove that they are meeting work requirements.

Frederica Freyberg:
So what costs do provisions of the bill add for the state of Wisconsin now fashioning its own budget?

Bill Hanna:
Yeah, we take eligibility enrollment very seriously here in Wisconsin. We run a very efficient program. We have one of the lowest eligibility error rates in the country. But this will require additional costs. We are really doubling the amount of work in a year to do eligibility for the 195,000 adults that this would subject to, meaning the state and county eligibility workers will need to hire more workers, and we will need to make changes to our system in order to verify and collect that work requirement information. We estimate it will cost us about $5.5 million each year to implement these changes in Wisconsin.

Frederica Freyberg:
On Foodshare, the House bill would mean about 90,000 people would lose that assistance according to your office. How does the bill result in those people losing those benefits?

Bill Hanna:
Yeah, there are already work requirements in FoodShare today, but the bill drastically changes who is required to meet the food requirements. Today, it’s adults between 18 and 54 who do not have dependent children. What the bill does is expands that to adults between 18 and 65 and includes adults with children if their children are not under age seven. So you’ve really increased the number of adults that need to meet work requirements in order to maintain their FoodShare benefits. And we estimate that about 90,000 individuals would likely lose their FoodShare benefits because of this expanded requirement.

Frederica Freyberg:
So the bill would also start penalizing the state for SNAP error rates, costing Wisconsin $207 million annually. What are those errors?

Bill Hanna:
Yeah, errors are just that. They’re errors, right? It’s not fraud. Determining Medi — FoodShare eligibility, it’s complex. And occasionally there are mistakes. If you think about doing your taxes and occasionally there is a mistake, there’s a lot that changes in people’s lives. Think about this population. They’re often doing gig work, meaning their income can change. There’s a lot of deductions that go into calculating it. So it’s complex in getting it to the dollar accurate. We already have one of the lowest error rates in the country. In fact, error rate went down last year. We’re well below the national average. The national average is 11.7. Wisconsin is at 4.4. But the bill continues to sort of narrow that tolerance for any — even $1 error in calculating payments. It also is an incredible cost shift, not just for the error rate, because what it does for the first time is requires states to contribute towards FoodShare benefits, which at a minimum will cost us $69 million a year in Wisconsin. It also changes the amount of the administrative costs that the federal government will pay. Today, they pay 50% of those costs, split 50/50 with the state. Going forward, they would only cover 25% of the cost. So that’s an additional $51 million for us to just run the program that we run today that is a well-run program, and the bill gives us no additional tools to control costs or any other flexibilities to try to really control costs in the FoodShare program.

Frederica Freyberg:
Well, we appreciate your information. Bill Hanna, thanks very much.

Bill Hanna:
Thank you.